Bladder Diverticula
(Plural of diverticulum)
A bladder diverticulum is a pouch or sac-like outpouching of the bladder wall that protrudes through a weak area in the muscular layer. It may be congenital or acquired, and it can trap urine, leading to complications like infection, stones, or even tumors.
🔍 Types
| Type | Description |
|---|---|
| Congenital | Rare; usually solitary; due to a developmental defect in bladder wall musculature |
| Acquired | More common; often multiple; associated with bladder outlet obstruction (e.g., BPH, stricture) |
⚠️ Causes of Acquired Diverticula
- Benign prostatic hyperplasia (BPH)
- Urethral stricture
- Neurogenic bladder
- Chronic bladder overdistension
These conditions cause increased intravesical pressure, forcing the bladder mucosa to herniate through weakened muscular layers.
🩺 Symptoms
May be asymptomatic or present with:
- Recurrent UTIs
- Urinary retention or incomplete emptying
- Double voiding (voiding again shortly after)
- Hematuria
- Bladder stones
- Rarely, diverticular carcinoma
🧪 Diagnosis
- Ultrasound
- May show outpouching, especially post-void
- Voiding cystourethrogram (VCUG)
- Reveals diverticula during filling and voiding
- Cystoscopy
- Direct visualization of the diverticular neck and interior
- CT Urogram / MRI
- Helpful in complex cases or to evaluate for malignancy
🛠️ Complications
- Urinary stasis → infections, stones
- Tumors (usually urothelial carcinoma, rare but serious)
- Bladder outlet obstruction
- Vesicoureteral reflux (if diverticulum is near ureteric orifice)
🩹 Treatment
✅ If Asymptomatic:
- Observation, regular monitoring
⚕️ If Symptomatic or Complicated:
- Treat underlying cause (e.g., relieve BPH or obstruction)
- Surgical options:
- Diverticulectomy: removal of diverticulum (open, laparoscopic, or robotic)
- Endoscopic unroofing: if small and accessible
- TURP or urethral dilation: for associated outlet obstruction
- Surveillance:
- Periodic cystoscopy and imaging if there’s a cancer risk
📈 Prognosis
- Good with treatment
- Requires long-term follow-up if associated with recurrent infections, obstruction, or suspected malignancy